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After surviving being shot and stabbed at the end of the previous film, Jerry Blake is institutionalized in Puget Sound, Washington. Blake has meetings with his psychiatrist. He escapes the institution after murdering the psychiatrist and a guard. He dons the guard's uniform to help him escape. After robbing and killing a traveling salesman, Blake checks into a hotel, alters his appearance, assumes the identity of deceased publisher Gene F. Clifford, and travels to Palm Meadows, Los Angeles.

Arriving in Palm Meadows, Gene now posing as a psychiatrist, meets Carol Grayland and leases a house across the street from her and her 13-year-old son, Todd. During a session with the wives of the neighborhood, Gene learns Carol's husband, Philip, left his family the previous year. Gene begins courting Carol, eventually winning over her and Todd. Gene's plan to continue his courtship with Carol is soon complicated when Phil returns, wanting to reconcile with his wife. Needing Phil out of the way, Gene persuades Carol to send him over for a meeting, during which Gene smashes a bottle on his head then stabs him to death. He covers up Phil's disappearance afterwards by making it look like he simply ran off again. With Phil gone, Gene and Carol arrange to get married.

Matty Crimmins, local mail carrier, and Carol's best friend become suspicious of Gene and begins looking through Gene's mail. She finds a letter addressed to the real Gene Clifford (which includes a photograph revealing him to be African American). She confronts Gene, demanding to know who he really is, although Gene tries to make it look like the letter was sent to the wrong person. Gene persuades her to let him tell Carol the truth about his past. Later that night, after making love to Carol, Gene sneaks into Matty's house and strangles her to death, making her death look like a suicide. On his way out, Gene takes Matty's last bottle of wine and crosses through the yard of Matty's blind neighbor Sam Watkins, who hears Gene whistling "Camptown Races," which he mentions to Carol the next day.

Despite Matty's death, the wedding proceeds as planned. While dressing in the church, Carol recognizes bottles of wine sent by Matty's parents as the same brand Gene had the other night, and overhears Todd whistling "Camptown Races", which he says Gene taught him. Thinking Gene may have had something to do with Matty's death, Carol confronts him, prompting Gene to attack Carol and Todd, whom he locks in a storage closet. As Gene prepares to kill Carol with a knife she used to stab him, Todd breaks out of the closet and saves his mother, knocking the knife out of Gene's hand and stabbing him in the chest with a claw hammer, apparently killing him. As Carol and Todd walk into the wedding ceremony, everyone is disgusted to see them covered in blood until Carol collapses on the floor. The film ends with Gene getting up, stumbling through the wedding party and collapsing on the floor by the wedding cake, weakly uttering "Till death...", then seemingly dying from his wounds.

After a test screening of the film, studio executives Harvey and Bob Weinstein complained about the lack of blood and demanded re-shoots. Jeff Burr refused and director Doug Campbell was hired to do the reshoots. In an interview, Burr commented, "they cut a little bit of [the film] out and they added some badly done blood effects. Badly done, because Terry O’Quinn refused to do it. Really, they were meaningless, so that was irritating."[2]

Stepfather II was originally intended to be released direct to video; however, the producers were impressed enough with the sequel that it was released into theaters. The film was given a limited release theatrically in the United States by Millimeter Films in November 1989.[3] It grossed $1,519,796 domestically at the box office.[4]

The film received mostly negative reviews. Variety stated "this dull sequel reduces the intriguing premise of the original Stepfather to the level of an inconsequential, tongue-in-cheek slasher film".[5] Richard Harrington of The Washington Post wrote that the film was cliche-ridden and lacked the reality-rooted horror that made the original film effective, finishing his review by stating "Stepfather 2 is just slick marketing trying to capitalize on unsettling art - and failing badly, at that".[6]

After the film's theatrical release, it was released on VHS by HBO Video in the United States and in Canada around the same time by Cineplex Odeon. In 2003, the film was released on DVD by Miramax Films and the same year in Canada by Alliance Atlantis; it included audio commentary with director Jeff Burr and producer Darin Scott. In 2009, to coincide with the release of the Screen Gemsremake of the original Stepfather, Synapse Films re-released Stepfather II on DVD with special features including the ones available on the Miramax and Alliance Atlantis releases, as well as new features such as a making-of documentary.[7][8]